COMBI: Communication for Behavioural Impact

This 31-slide PowerPoint presentation explores a method for strategic communication planning called Communication for Behavioural Impact (COMBI). The strategy, which originated in 1994 at a summer institute at New York University in the United States, involves developing a carefully planned and monitored communication programme to engage individuals, families, and communities to consider action with respect to specific behaviours which could make a difference in their lives. The foundation of the approach is integrated marketing communication (IMC). As explained here, the World Health Organization (WHO) began applying COMBI (originally called IMC/COMBI) based on the recognition that knowing what to do is different than doing it, but that coercion to enforce behaviour is not a viable approach. Other organisations have applied it, as well.

COMBI is a 10-step process (see slide 24 of the presentation for the steps) that involves 2 mantras, which are not just the job of the COMBI/communication for development (C4D) professional but a joint effort with technical/programme/evaluation specialists.

The first mantra is: Do nothing...make no posters, no t-shirts, no pamphlets, no videos, no caps, no websites, etc...do nothing, until specific, precise behavioural goals/objectives (SBOs) have been set out. The key, according to the presentation, is to make behavioural objectives specific and precise by applying:

• the SMART criteria: S = Specific, M = Measurable, A= Appropriate, R = Realistic, and T = Time-bound;
• the 4 + 1 Ws: Who will do What, Where, When,...and Why?;
• "HICDARM©" (explaining the gap between knowing and doing):
  1. First, we Hear about the new behaviour;
  2. then, we become Informed about it...
  3. and later become Convinced that it is worthwhile.
  4. In time, we make the Decision to do something about our conviction;
  5. later we take Action on the new behaviour.
  6. We await Re-confirmation that our action was a good one and, if all is well, we
  7. Maintain the behaviour.

The second mantra is: Do nothing...make no posters, no t-shirts, no pamphlets, no videos, no caps, no websites, etc...do nothing, until one has "SMACK-ed" - that is, carried out a Situational Market Analysis for Communication Keys). At the heart of this is listening to the consumer. Amongst the tools for SMACK-ing outlined here are: Force Field Analysis, HICDARM Analysis, SWOT (Strength, Weaknesses, Opportunities, Threats) Analysis, DILO (Day in the Life Of) Analysis, MILO (Moment in the Life Of) Analysis, TOMA (Top of the Mind) Analysis, Market Segmentation Analysis, Competitor Analysis (e.g. TAC-Take a Chance, Do nothing, Do something else), and/or the 4 C's of IMC (C = Consumer Need/Want/Desire and Related Product/Service/Behaviour; C = Cost; C = Convenience to get product or service or to carry out behaviour; C = Communication (integrated, engaged, synchronised, strategic communication ensuring behavioural focus throughout) using the "Five-Point Star Blend of Communication Interventions":

1. Administrative Mobilisation/Public Relations/Advocacy;
2. Community Mobilisation;
3. Advertising;
4. Personal selling/Interpersonal communication; and
5. Point-of-service promotion).

After a closer look at COMBI's "behavioural hook" approach, the presenter explores COMBI in action, noting organisations that have used the approach to address various communicable and non-communicable diseases - and where. Impact results are shared from various places where COMBI has been applied, including Malaysia, where COMBI has been used to address Dengue. In Johor Bahru, a Dengue COMBI programme was conducted over a 12-week period beginning in August 2001. Over the duration of the project, 85% of households in focus areas were inspecting their homes for breeding sites (in previous efforts less than 20% were carrying out these home inspections). A follow-up survey 3 months later showed that 70% were still maintaining the checks.

In conclusion, the presenter notes that COMBI has a "sharp, tunnel-vision focus on behavioural results", but that it requires "exquisite managerial discipline" and "can not be done on the cheap."